Cost Containment Meeting Application {WC-1021}

LDOL-WC 1021 - OSHA CONSULTATION COST CONTAINMENT MEETING APPLICATION. This form is used by Louisiana employers to request participation in the LWC Office of Workers’ Compensation Administration—OSHA Consultation cost-containment program. To qualify, an employer’s experience modifier rate (EMR) must be 1.50 or higher as of December 31 of the prior year. The application collects company and contact details, EMR, and the name/title of the authorized representative. Applicants must attach proof of the representative’s authority (e.g., job description, annual report, preprinted tax form, partnership act). The agency will confirm the date and location of the initial meeting in a follow-up communication. www.FormsWorkflow.com